Week 1 Flashcards
Function of IV disks
-attachments between vertebral bodies -allow for movement between vertebral bodies -shock absorbers
What are IV disks made of?
-outer fibrous part: anulus fibrosus; fibrocartilage -central mass: nucleis pulposus; elastin, proteoglycans, water
How do IV disks change with age?
-nuclei pulposi dehydrate and lose elastin and proteoglycans while gaining collagen. -lose their turgor (fullness), becoming stiffer and more resistant to deformation.
How do anterior longitudnal disks interact with IV disks?
covers and connects the anterolateral aspects of the vertebral bodies and IV discs
What is function of anterior longitudnal disks?
prevents hyperextension of the vertebral column
Contents of the vertebral canal
spinal cord, spinal nerve roots, spinal meninges, neurovascular structures
Where does spinal cord begin and end in an adult vs an embryo? Why?
-Adult: L1-L2 -Baby: S4-S5 -Because the vertebral column grows faster than the spinal cord; as a result, the cord “ascends” relative to the vertebral canal.
Where are enlargements of spinal cord located? Why?
Cervical and lumbar, because of the plexuses
Safest place to insert needle for lumbar puncture? Why?
-L4 and L5 - because the cauda equina is made of thin fibers that easily move out of the way
Ligamentum flavum -how do they work - function -composition -increased thickness
-connects the vertebrae from one lamina to the next - provides protection to the neural elements of the spine and provides stability by preventing excess motion between vertebrae -Composition 80% elastin and 20% collagen -can thicken with age
Ligaments that connect spinous processes
-supraspinous (from one tip of spinous process to next), interspinous (between two spinous processes), and nuchal (cervical region)
Pathway of needle in epidural
skin–sub cut–supraspinous ligament–intraspinous ligament–ligamentum flavum
Craniovertebral joints -what do they connect, type of joint, movement of joint
-atlanto-occipital: between occipital bone of cranium and atlas (C1); pivot; flexion and extension of head, sideways tiliting of head -atlanto-axial: between atlas (C1) and axial (C2); condyloid; rotation
venous drainage of spinal cord
- spinal veins and basivertebral veins (vertebral bodies) drain into venous plexuses along the vertebral column, both inside and outside the vertebral cana; those drain into intervertebral veins which drain into the vertebral veins of neck and trunk
spinal veins
-veins that brain the spinal cord and bone of spine (except for spinous body)
Parent spinal arteries
Parent arteries: -cervical: vertebral and ascending cervical arteries -thoracic: posterior and intercostal arteries -iliolumbar and lateral/medial sacral arteries -will encircle entire vertebral column and branches coming off will feed the bone
spinal nerves
-meninges and vertebral column are innervated by meningeal nerves which are the first branches to arise from all 31 pairs of spinal nerves
Equatorial and Posterior arterial branches
- Equitorial: feed vertebral body -Posterior: feed vertebral arch
Spinal branches
supply bones, periosteum, ligaments and meninges that are in the epidural space
Partial thick biopsy techniques
-shave excision -curettage
Full thickness biopsy
-punch -excisional
Shave excision -when is it used -why it should not be used -advantages
- to remove the protruding portion of a raised skin lesion when a full-thickness sample is not required -contraindicated for melanoma because of inability to gauge how deep the invasion is - simple and less expensive; does not disrupt the skin
Curettage -when is it used -disadvantages
- biopsy removal of basal cell carcinomas, hyperkeratotic epidermal lesions, and neoplastic tissue (necrotic) - multiple fragments of specimen are produced and the presence of disease-free margins cannot be determined
Punch -when is it used -type of dx used for
-complete removal of small lesions (<5 mm) or whenever there is doubt as to the diagnosis or optimal treatment for a particular lesion. -recommended when melanoma is a significant consideration because it provides information on the depth of the lesion.
Excisional -when is it used -benefit -tyoe of dx used for
to remove an entire lesion in a manner that obtains a full-thickness specimen of skin -diagnosis and treatment can be carried out at same time - removal of malignant, or suspected malignant, skin lesions
Complications of skin sampling
-Pain -Infection -Excessive bleeding -Scarring -Missing correct dx -Allergic reaction -Recurrence
5 major functions of skin
-protection: keratin is tough providing protection from invaders, melanin protects from sunrays -sensory: receptors in skin allows for sensations to be felt (heat, pain, pressure) -thermoregulatory: insulates with fat and releases heat through sweating - sex signaling: phermones produced in sweat glands -vit D: allows for absorption of vitamin D from the sun
Melanocytes
-located in the epidermal basal layer and synthesize melanin granules and transfer them into neighboring keratinocytes.
Langerhaan cells
-APC’s located in spinous layer of skin to alert tcells when there is micro-organism attack
Merkel cells
basal epidermal layer have high tactile sensitivity and function as mechanoreceptors
Skin appendages -what is it -examples
-skin-associated structures that serve a particular function including sensation, contractility, lubrication and heat loss. -examples: hair, sebaceous/sweat glands, nails
Skin appendages in scalp
-increased hair follicles and sebaceous glands
Skin on arm -why is it thin? -what adnexal structure not present
-lack of stratum lucidum and thin stratum corneum (in thick skin, corneum is very thick)
Skin on palms and soles of feet
-pronounced dermal papillae (finger prints) -thick stratum corneum due to increase of abrasions in this area
Innervation of skin and back muscles
-intrinsic vs extrinsic
-skin on back and intrinsic muscles of back enter/exit dorsal primary rami -extrinsic muscles enter/exit through ventral primary rami
Superficial fascia -function
-facilitates skin over underlying structures -passage for cutaneous nerves and blood vessels -protects body from heat loss (fat)
Deep fascia
-allows for movement of muscle -carries nerves and blood vessels of muscles -compartmentalizes muscle groups and helps minimize friction between groups
Triangle of auscultation -borders -significance -instructions to patient
-inferior portion of trap, medial border of scapula, lat -relatively thin layer of tissue here allows lung sounds to be more easily heard with a stethoscope; good for patients with thick back musculature -usually covered by scapula, ask patient to cross arms across their chest and bend forward
Pars anticularis -what is it
-cloumn of bones connecting the superior and inferior articular process
Scotty dog -other name -parts of body and what they represent -what happens with sondylolithesis
-another name for pars arnticularis -ear: superior articular process; snout: transverse process; eye: pedicle; neck: isthmus; forelimb:inferior articular process; body: spinous process; hind limb: contralateral inferior articular process -dog is decapitated
curvatures of vertebral column
-kyphosis: thoracic and sacrum-natural, begin to form during fetal development -lodosis: cervical and lumbar-begin to form once weight is beared
How does excessive thoracic kyphosis occur?
-humpback: erosion of anterior part of vertebrae -we
How does excessive lumbar lordosis occur?
-weakened trunk musculature -late pregnancy due to difference in normal line of gravity -obesity due to increased weight of abdominal cavity
How does scoliosis occur?
-deformities: only half of vert form -asymmetrical weakness of intrinsic back muscles
what occurs with vertebral motions -extension -flexion -side bending -rotation
-extension: spinous bodies move apart, spinous process get closer together, posterior portion of IV disk is compressed -flexion: spinous bodies get closer together, spinous process move apart, anterior portion of IV disk is compressed - side bending: one set of transverse processes moving closer together, opposite moving apart, IV disk is compressed on side where transverse process are closer together -rotation: spinal bodies moving in opposite ways over IV disk
Sacrum
MEMORIZE
Vertebrae
-Body, pedicle, lamina, spinous process, transverse process, vertebral foramen, superior/inferior articular process, superior/inferior vertebral notch
MEMORIZE
Difference in vertebrae
MEMORIZE
